Organization
NANDINI KIRI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANDINI KIRI MD PA (PHYSICIAN)
(941) 883-5454
Entity
Organization
Contact information
Practice address
3390 TAMIAMI TRL, SUITE 101, PORT CHARLOTTE, FL 33952-8157
(941) 883-5454
(941) 883-5457
Mailing address
PO BOX 495237, PORT CHARLOTTE, FL 33949-5237
(941) 883-5454
(941) 883-5457
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME82594
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05106
BCBS FL
FL
01
—
26157710
MEDICAID
FL
01
—
P00058990
RR MEDICARE
FL
Enumeration date
08/23/2007
Last updated
12/07/2011
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